(Transcript from World News Australia Radio)
Doctors' groups are worried the federal government may accept a proposal to introduce a co-payment for doctor visits.
The government has refused to speculate about the proposed scheme which has been put to the national Commission of Audit.
But critics claim it would destroy Medicare and limit access to GPs for some community groups.
Kerri Worthington reports.
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The Australian Centre for Health Research has made a submission to the federal government's Commission of Audit proposing a five-dollar fee for bulk-billed GP visits, to help pay for Medicare.
The author of the proposal, Terry Barnes, is a former adviser to Tony Abbott when he was health minister in the Howard government.
Mr Barnes has told the ABC the fee is small enough to be manageable for most people and is unlikely to deter people from seeking help.
"The problem is that taxpayers can't sustain Medicare, growth in Medicare year on year, dollar on dollar. What we are suggesting is that a small contribution by patients at the time they go and see a doctor puts more money in GPs pockets, plus the Medicare rebate, it keeps the whole system going."
The Federal Health Minister Peter Dutton says he will not comment on speculation around what the Commission of Audit may or may not recommend.
Acting opposition leader Penny Wong says Mr Dutton's refusal to rule out the co-payment is effectively a broken promise not to raise healthcare costs.
Senator Wong has predicted the move, if adopted, will clog up hospital emergency departments.
The Australian Medical Association has reacted cautiously to the proposal, urging the Government to ensure it does nothing to deter people from seeking help from their GP and increasing the likelihood of developing chronic diseases that need hospital treatment.
AMA federal president Steve Hambleton says something does need to be done about Australia's public healthcare system.
"This is a suggestion going to a Commission of Audit. There's a whole lot of deliberation at that level before a recommendation is made. The government is quite rightly saying 'look, all things are on the table'. We've got a fiscal problem in this country, we've got healthcare costs growing at eight per cent. This is not just Australia. We see the same problems in the US. We see the same problems in all first world countries with non-communicable diseases and rising healthcare costs. All of us are trying to grapple with these problems and trying to make our health systems more efficient and we've all got to look at various drivers to make that happen."
But Dr Hambleton says the Government needs to focus on disease prevention as a way of reducing healthcare costs.
"If we're trying to solve healthcare costs overall we've really go to look at what's driving those healthcare costs, and that's our ability to continue to treat significant numbers of people with chronic disease. And I guess we're keeping people alive longer. If we want to turn those things around $5 at the GP might not be the right solution. But things like tobacco, alcohol, over-nutrition and under-exercise, that's really going to change our healthcare costs going forward."
Another doctors' organisation has raised concerns that the proposed co-payment will hurt the most vulnerable groups in Australian society.
Doctors Reform Society President Con Costa says the extra fees could deter people from lower socio-economic backgrounds going to the doctor and lead to bigger health costs down the road.
Under the proposal, pensioners and concessions card holders would be exempt and families would receive 12 free visits before they must start paying.
But Dr Costa says he's sceptical about the proposed exemptions.
"There's always exemptions in the beginning. But we know once you put the foot in the door it then just increases. Out feeling is that it will start off at five dollars and then start increasing year by year. And don't forget that when you start charging a five dollar rebate by the GP you're going to get the x-rays, the blood pathology, everyone else will start to follow."
